4-E-Verify Affidavit-Contractor.pdf

65 KB Posted

Attached to
Public Bike Share Program: Equipment, Operations, and Services
Solicitation number
26-1001
Issued by
Fulton County, Georgia

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This document is an Affidavit Verifying Contractor Participation in Federal Work Authorization Program (E-Verify) from the City of Alpharetta, Georgia, specifically related to the Public Bike Share Program: Equipment, Operations, and Services. The affidavit requires a contractor to verify their compliance with O.C.G.A. § 13-10-91 by confirming their registration and continued use of the E-Verify federal work authorization program throughout the contract period. The contractor must commit to using E-Verify for employment verification, notify the city if they cease using the program, and ensure that subcontractors also comply with the same requirements.

The affidavit does not contain specific pricing, funding, or detailed project scope information. Its primary purpose is to legally document the contractor's commitment to using the E-Verify system to confirm the work authorization status of employees involved in the Public Bike Share Program. The document requires the contractor to sign and have the affidavit notarized, with provisions for submitting additional documentation like affidavits, drivers' licenses, and identification cards to the City of Alpharetta within five business days of receipt. The contractor acknowledges that failing to use the E-Verify program constitutes a material breach of the contract.

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Other files

File Type Posted
2-IRS Form W-9 March 2024.pdf PDF
6-RFQ 26-1001 Statement of Qualifications.pdf PDF
1-Alpharetta LVP Form.pdf PDF
5-RFQ 26-1001 Information and Contract TC.pdf PDF
3-Disclosure-Debarment Required Form.pdf PDF

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City of Alpharetta, GA Procurement Required Document Affidavit Verifying Contractor Participation in Federal Work Authorization Program (E-Verify)

AFFIDAVIT VERIFYING CONTRACTOR PARTICIPATION IN

FEDERAL WORK AUTHORIZATION PROGRAM (E-Verify)

The undersigned contractor ("Contractor") executes this Affidavit to comply with O.C.G.A § 13-10-91 related to any contract to which Contractor is a party that is subject to O.C.G.A. § 13-10-91 and hereby verifies its compliance with O.C.G.A. § 13-10-91, attesting as follows:

a) The Contractor has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program;

b) The Contractor will continue to use the federal work authorization program throughout the contract period, including any renewal or extension thereof;

c) The Contractor will notify the City of Alpharetta in the event the Contractor ceases to utilize the federal work authorization program during the contract period, including renewals or extensions thereof;

d) The Contractor understands that ceasing to utilize the federal work authorization program constitutes a material breach of Contract;

e) The Contractor will contract for the performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the Contractor with the information required by O.C.G.A. § 13-10-91(a), (b), and (c);

f) The Contractor acknowledges and agrees that this Affidavit shall be incorporated into any contract(s) subject to the provisions of O.C.G.A. § 13-10- 91 for the project listed below to which Contractor is a party after the date hereof without further action or consent by Contractor; and

g) The Contractor acknowledges its responsibility to submit copies of any affidavits, drivers' licenses, and identification cards required pursuant to O.C.G.A. § 13-10-91 to the City of Alpharetta within five business days of receipt.

Federal Work Authorization User Identification Number Date of Authorization

Name of Contractor Name of Project

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed date ___________________ in _______________ (city), __________ (state).

Signature of Authorized Officer or Agent

Printed Name and Title of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME

ON THIS THE _______ DAY OF _____________, 20______.

NOTARY PUBLIC

My Commission Expires: _____________________________

(Notary Stamp)

AFFIDAVIT VERIFYING CONTRACTOR PARTICIPATION IN FEDERAL WORK AUTHORIZATION PROGRAM (E-Verify)

Federal Work Authorization User Identification Number:
Date of Authorization:
Name of Contractor:
Name of Project: Public Bike Share Program: Equipment, Operations, and Services
Executed date:
in:
state:
Printed Name and Title of Authorized Officer or Agent:
My Commission Expires:
Year:
Month:
Day:

File details come from the government source that posted it. Updated .